Chronic renal Insufficiency Lu Fuming Division of Nephrology, Huashan Hospital, Fudan University
1 Chronic Renal Insufficiency Lu Fuming Division of Nephrology,Huashan Hospital,Fudan University
Chronic Renal Insufficiency Pathogen and pathogenesis Manifestation La boratory examination Diagnosis and differential diagnosis Treatment
2 Chronic Renal Insufficiency • Pathogen and pathogenesis • Manifestation • Laboratory examination • Diagnosis and differential diagnosis • Treatment
Etiology primary glomerular diseases ypertensive nephrosclerosis dia betic nephropathy chronic pyelonephritis multicystic kidney systemIc lupus nephritis
3 Etiology • primary glomerular diseases • hypertensive nephrosclerosis • diabetic nephropathy • chronic pyelonephritis • multicystic kidney • systemic lupus nephritis
Pathogenesis Mechanism associated with exacerbation of renal function Mechanism associated with uremic symptom
4 Pathogenesis • Mechanism associated with exacerbation of renal function • Mechanism associated with uremic symptom
Mechanism Associated with Exacerbation of renal function Hyperfiltration theory Effect of proteinuria Trade-off hypothesis in acidosis Disturbance of lipid metabolism Tubulointerstitial injury Renal hypoxia
5 Mechanism Associated With Exacerbation of Renal Function • Hyperfiltration theory • Effect of proteinuria • Trade-off hypothesis in acidosis • Disturbance of lipid metabolism • Tubulointerstitial injury • Renal hypoxia
Mechanism Associated With Uremic Symptom · Uremic toxins malnutrition trade-off hypothesis Endocrine dysfunction
6 Mechanism Associated With Uremic Symptom • Uremic toxins • malnutrition • trade-off hypothesis • Endocrine dysfunction
Manifestation of the Uremic Syndrome Gastrointestinal Neurologic Cardiovascular · Dermatologic Hematologic Endocrinologic Pulmonary ·0 phthalic
7 Manifestation of the Uremic Syndrome • Gastrointestinal • Cardiovascular • Hematologic • Pulmonary • Neurologic • Dermatologic • Endocrinologic • ophthalmic
Gastrointestinal manifestation Anorexia progressing to nausea and vomiting Stomatitis and gingivitis Parotitis Peptic ulcer diathesis Gastritis duodenitis and enterocolitis Pancreatitis ascites
8 Gastrointestinal Manifestation • Anorexia progressing to nausea and vomiting • Stomatitis and gingivitis • Parotitis • Peptic ulcer diathesis • Gastritis , duodenitis and enterocolitis • Pancreatitis • Ascites
Cardiovascular manifestation Accelerated atherosclerosis Cardiomyopathy ° pericarditis
9 Cardiovascular Manifestation • Accelerated atherosclerosis • Cardiomyopathy • pericarditis
Hematologic Manifestation · Anemia Altered neutrophilic chemotaxis Depressed lymphocyte function Platelet dysfunction
10 Hematologic Manifestation • Anemia • Altered neutrophilic chemotaxis • Depressed lymphocyte function • Platelet dysfunction